Drugs are divided into categories referred to as ‘schedules’ based on properties such as their potential for abuse, safety profile and legitimacy as a medical treatment. These schedules range from I to V with schedule I medications being those with an extremely high potential for abuse and no legitimate medical application and with schedule V benig those with a low potntial for abuse. In the overwhelming majority of states, nurse practitioners enjoy the freedom to prescribe drugs in schedules II-V.
A handful of states, however, place more stringent limits on nurse practitioners’ prescribing ability. In six states, nurse practitioners are not permitted to prescribe schedule II controlled substances (or can only do so under very limited conditions).
1. Arkansas (limited)
In Arkansas, nurse practitioners are restricted to prescribing schedule III-V controlled substances and hydrocodone-containing medications from schedule II of the Controlled Substances Act. In order to prescribe this limited number of schedule II meds, NPs must also have this ability outlined in a collaborative practice agreement with a collaborating physician. Continuing education requirements and other collaborative requirements must also be met.
Georgia’s strict when it comes to NP scope of practice. According to the Georgia Board of Nursing, nurse practitioners in the state may only prescribe schedule III-V drugs. Prescribing of schedule II substances is limited to physicians.
3. Missouri (limited)
Nurse practitioners practicing in Missouri are permitted to prescribe a limited number of schedule II controlled substances, hydrocodone combination products. The state makes it difficult for NPs to prescribe controlled substances of any schedule, even medications labeled as schedules III-V. Missouri requires 1000 hours of postgraduate experience, 300 hours of precepted prescribing experience, and a special state-level registration in order to prescribe.
NPs in Oklahoma are not permitted to prescribe schedule II drugs. Furthermore, they may only prescribe schedule III-V drugs for no more than a 30-day supply. The state’s Exclusionary Formulary for Advanced Practice Nurses with Prescriptive Authority document also outlines a list of medications that may not be prescribed by NPs.
5. West Virginia
West Virginia does not allow NPs to prescribe schedule II controlled substances. The state does allow NPs to prescribe schedule III-V controlled substances and to do so without physician oversight after the first three years of practice.
While these five states prohibit NPs from prescribing schedule II controlled substances, or only allow them to do so in a limited capacity, other states may also place some limitations on NPs when prescribing schedule II meds. These limitations may include the length of medication supply or specialty areas in which NPs are allowed to prescribe them to name a few. Additionally, states may place certain qualifications such as continuing education requirements or physician supervision requirements around the prescribing of scheduled medications. Be sure to know and understand the scope of practice prescribing laws in your state to ensure that you’re practicing in compliance with state law.
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